Xiao Yamei, Xu Xiaomei
Department of Neurosurgery, Affiliated Hospital of Chengdu University, Chengdu, China.
Department of Nursing Care, Affiliated Hospital of Chengdu University, Chengdu, China.
Medicine (Baltimore). 2025 Feb 28;104(9):e41547. doi: 10.1097/MD.0000000000041547.
Stroke remains a leading cause of disability and mortality globally, necessitating effective rehabilitation strategies to improve patient outcomes. This study aimed to evaluate the effectiveness of specialized routine nursing interventions, nursing interventions based on the Information-Motivation-Behavioral Skills (IMB) model, and nursing interventions combining the IMB model with a hospital-community-family triad model in patients with acute ischemic stroke.
A total of 120 patients with acute ischemic stroke were randomly assigned to one of 3 groups: Control Group (specialized routine nursing interventions, n = 40), Experimental Group 1 (IMB model-based interventions, n = 40), and Experimental Group 2 (IMB model combined with hospital-community-family triad, n = 40). Clinical outcomes, including NIHSS scores, medication adherence, and functional exercise adherence, were assessed at discharge and 6 months post-intervention. Patient satisfaction was also evaluated.
No differences were noted between groups at baseline. Both IMB model-based interventions (Experimental Groups 1 and 2) significantly improved NIHSS scores, medication adherence, and functional exercise adherence compared to the Control Group at both discharge and 6 months post-intervention. The combined intervention (Experimental Group 2) yielded the most pronounced improvements. Patient satisfaction was highest in Experimental Group 2, followed by Experimental Group 1 and the Control Group. These improvements were greater in Experimental Group 2 than Group 1. The adjusted multivariate regression models indicated significant improvements in all measured outcomes for the experimental groups, with lower AIC and BIC values suggesting better model fit.
Nursing interventions based on the IMB model, particularly when combined with a hospital-community-family triad, significantly enhance clinical outcomes and patient satisfaction in stroke rehabilitation. These findings advocate for the integration of comprehensive, behavior-focused interventions in routine stroke care, addressing critical gaps in current rehabilitation practices. Future research should explore the long-term benefits and broader applicability of these interventions.
中风仍是全球残疾和死亡的主要原因，因此需要有效的康复策略来改善患者预后。本研究旨在评估专业常规护理干预、基于信息 - 动机 - 行为技能（IMB）模型的护理干预以及将IMB模型与医院 - 社区 - 家庭三联模型相结合的护理干预对急性缺血性中风患者的有效性。
总共120例急性缺血性中风患者被随机分为3组之一：对照组（专业常规护理干预，n = 40）、实验组1（基于IMB模型的干预，n = 40）和实验组2（IMB模型与医院 - 社区 - 家庭三联模型相结合，n = 40）。在出院时和干预后6个月评估临床结局，包括美国国立卫生研究院卒中量表（NIHSS）评分、药物依从性和功能锻炼依从性。还评估了患者满意度。
各组在基线时无差异。与对照组相比，基于IMB模型的干预（实验组1和2）在出院时和干预后6个月均显著改善了NIHSS评分、药物依从性和功能锻炼依从性。联合干预（实验组2）产生了最显著的改善。实验组2的患者满意度最高，其次是实验组1和对照组。实验组2的这些改善大于实验组1。调整后的多变量回归模型表明实验组所有测量结局均有显著改善，较低的赤池信息准则（AIC）和贝叶斯信息准则（BIC）值表明模型拟合更好。
基于IMB模型的护理干预，特别是与医院 - 社区 - 家庭三联模型相结合时，可显著提高中风康复的临床结局和患者满意度。这些发现提倡将全面的、以行为为重点的干预措施纳入常规中风护理，解决当前康复实践中的关键差距。未来的研究应探索这些干预措施的长期益处和更广泛的适用性。
